title: The development of a population-based automated screening procedure for PTSD in acutely injured hospitalized trauma survivors.
abstract: OBJECTIVE
  This investigation aimed to advance posttraumatic stress disorder (PTSD) risk prediction among hospitalized injury survivors by developing a population-based automated screening tool derived from data elements available in the electronic medical record (EMR).
  
  
  METHODS
  Potential EMR-derived PTSD risk factors with the greatest predictive utilities were identified for 878 randomly selected injured trauma survivors. Risk factors were assessed using logistic regression, sensitivity, specificity, predictive values and receiver operator characteristic (ROC) curve analyses.
  
  
  RESULTS
  Ten EMR data elements contributed to the optimal PTSD risk prediction model including International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) PTSD diagnosis, other ICD-9-CM psychiatric diagnosis, other ICD-9-CM substance use diagnosis or positive blood alcohol on admission, tobacco use, female gender, non-White ethnicity, uninsured, public or veteran insurance status, E-code identified intentional injury, intensive care unit admission and EMR documentation of any prior trauma center visits. The 10-item automated screen demonstrated good area under the ROC curve (0.72), sensitivity (0.71) and specificity (0.66).
  
  
  CONCLUSIONS
  Automated EMR screening can be used to efficiently and accurately triage injury survivors at risk for the development of PTSD. Automated EMR procedures could be combined with stepped care protocols to optimize the sustainable implementation of PTSD screening and intervention at trauma centers nationwide.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA 98104, USA.
authors.forename: Joan
authors.initials: J
authors.lastname: Russo
authors.forename: Wayne
authors.initials: W
authors.lastname: Katon
authors.forename: Douglas
authors.initials: D
authors.lastname: Zatzick
mesh_terms: D000328:Adult; D057286:Electronic Health Records; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008403:Mass Screening / Q000379:methods; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012737:Sex Factors; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis*; D019966:Substance-Related Disorders / Q000523:psychology; D014947:Wounds and Injuries / Q000523:psychology*
keywords: EMR; Information technology; Injury; PTSD; Screening